Falls in Cirrhosis - Prior Falls and Frailty Identify Patients at Highest Risk: Hepatology Communications | September 2026
What Did the Study Find?
This large CAPriCORN multicenter study evaluated 42,046 patients with cirrhosis over a mean follow-up of approximately 3.4 years to identify predictors of falls and recurrent falls.
- 7.1% of patients experienced a fall, including 2.6% within the first year after cirrhosis diagnosis.
- Previous fall history was the strongest predictor of another fall (HR 5.69).
- Frailty independently increased fall risk:
- Severe frailty: HR 2.37
- Intermediate frailty: HR 1.71
- Importantly, 38.4% of patients who fell experienced another fall during follow-up.
- Among patients with recurrent falls, 35% experienced another fall within one year.
- Previous falls (HR 1.50) and severe frailty (HR 1.51) were the strongest predictors of a second fall.
- Patients with severe frailty had a 10-year cumulative fall incidence of 19.6%.
Why Does It Matter?
Falls are often overlooked during routine cirrhosis assessment, despite their potential consequences, including fractures, hospitalization, functional decline and loss of independence.
This study demonstrates that fall risk is not determined simply by age or liver disease severity. Prior falls and measurable frailty provide clinically useful information for identifying vulnerable patients.
GastroAGI Takeaway
In every cirrhosis clinic, ask one simple question: “Have you fallen in the past year?”
A previous fall identifies a particularly high-risk patient, while frailty further increases the likelihood of both first and recurrent falls.
These findings support incorporating routine fall-history assessment, frailty screening, medication review, nutritional optimisation, and balance/strength interventions into comprehensive cirrhosis care.
The clinical implication is especially relevant alongside the recent LiveSMART randomised trial, which reported fewer falls with lactulose followed by TeleTai-Chi in selected patients with cirrhosis.
